EA Health Research Journal

Navigating Scientific Inquiry in East Africa Amidst Declining Research Funding

2025-10-29T20:01:46+00:00

East African scientific research confronts an unprecedented funding crisis that has fundamentally transformed the region’s research landscape. Traditional funding mechanisms, heavily dependent on international grants and donor aid, have proven increasingly unsustainable amid global economic volatility, shifting donor priorities, and persistent COVID-19 impacts. Between 2022 and 2024, research funding to sub-Saharan Africa declined by approximately 18%, with East Africa experiencing particularly severe reductions as university research budgets stagnated while inflation eroded purchasing power by 15-20% annually across Kenya, Uganda, Tanzania, Rwanda, Ethiopia, and Sudan.
Even if the traditional funding reduction undermined scientific production in the EA region at the beginning, an impressive capacity of resiliency and innovation was thereafter quickly observed that catalyzed unprecedented innovation and collaboration among researchers. Rather than diminishing scientific capacity, this funding crisis has catalyzed unprecedented innovation and collaboration, spurring the development of resilient, self-sustaining research models that maintain scientific excellence despite severe resource constraints. This paper examines 6 transformative case studies that demonstrate how East African researchers have revolutionized scientific inquiry approaches, creating sustainable alternatives to traditional funding-dependent models through a comprehensive analysis spanning 2020-2025.
The cases described in this paper reveal comprehensive strategic frameworks integrating diversified funding portfolios, resource-efficient methodologies, robust community engagement ensuring research relevance, and collaborative networks facilitating expertise and infrastructure sharing. Successful programs strategically leverage expanding digital connectivity, open science practices, and South-South partnerships while systematically building sustainable local capacity and maintaining rigorous scientific standards. Strategic policy engagement and research translation create additional sustainability pathways by aligning research priorities with pressing societal needs and generating diverse funding opportunities.

Association Between COVID-19 Vaccination Uptake and Socio-Demographic Characteristics Among Pregnant Women in Kenya

2025-10-29T20:01:46+00:00

Background: Vaccination is considered more cost-effective in controlling the spread of COVID19 compared to other preventative measures. Pregnant women infected with COVID19 were likely to have severe COVID19 complications compared to uninfected women. This study examined the relationship between COVID19 vaccination uptake and socio-demographic characteristics among pregnant women in Kenya.
Methods: We conducted a secondary analysis using data from a pilot study examining COVID19 vaccination uptake among pregnant women in Kenya. We used descriptive analysis to report the proportions and chi 2 to assess if there are any significant differences between groups. Our primary outcome was COVID19 vaccination uptake. We performed logistic regressions.
Results: The predominant age groups of study participants were between 25-29 years (45.1%) and 30-39 years (45.1%). The majority of the pregnant had received COVID19 vaccination, with 87% having completed the full vaccine dosage. There was a higher uptake of adenovirus vector vaccines compared to mRNA COVID19 vaccines. Pregnant women between 30-39 years were 3.81 times more likely to have received COVID19 vaccination compared to those 25-29 years (aOR: 3.81; 95% CI: 1.28 -11.39, P=.017). After adjustment, workplace requirements for COVID-19 vaccination were associated with increased odds of vaccination (aOR: 4.65; 95% CI 1.32-16.42). The study did not show any significant relationship between comorbid conditions during pregnancy and COVID19 vaccination
Discussion: The variations of uptake by age-group cohorts, education levels, and vaccine workplace requirements suggest a need for further and more robust research on COVID19 vaccination among pregnant women. While workplace vaccination requirements may have prompted COVID19 vaccination among pregnant women in this sample, the results cannot be generalized to the general population. However, our findings underscore the importance of effective public health policies at the institutional, local and national levels.

Knowledge, Attitude, and COVID-19 Vaccination Uptake Among Drug Dispensers in Community Pharmacies: A Cross-Sectional Study

2025-10-29T20:01:46+00:00

Background: COVID-19 is a respiratory disease caused by Severe Acute Respiratory Syndrome coronavirus 2 (SARS-COV-2). Drug dispensers are at risk of contracting COVID-19. This study aimed to assess the knowledge, attitude, and COVID-19 vaccination uptake among drug dispensers in community pharmacies.
Methods: A cross-sectional study was conducted among drug dispensers in community pharmacies in Dar es Salaam from January to June 2022. Participants in the study were pharmacists, pharmaceutical technicians, pharmaceutical assistants, and Accredited Drugs Dispensing Outlets (ADDO) dispensers. The calculated minimum sample size was 360. A stratified sampling technique was used to obtain the number of pharmacies and drug dispensers required for each district. Data was collected using a self-administered, semi-structured questionnaire. To determine the predictors of COVID-19 vaccination status by the drug dispensers, multivariable binary logistic regression was performed.
Results: A total of 375 participants were included. More than half (57.0%) of participants had good knowledge of COVID-19 vaccines, while 203 (54.1%) of respondents had a positive attitude. About 111 (29.6%) of respondents had received the COVID-19 vaccine. Drug dispensers aged 50 years and above and pharmacists were more likely to have received the COVID-19 vaccine (AOR 58.82; 95% CI, 7.407 to 500.0; P<.001) and (AOR 5.025; 95% CI, 2.062 to 12.346, P=.005), respectively.
Conclusion: Drug dispensers in community pharmacies possessed a good level of knowledge regarding COVID-19 vaccination; however, gaps in attitude and vaccine uptake persisted. Strengthening educational campaigns through professional associations, utilizing digital platforms for information dissemination, and integrating vaccine promotion into continuing professional development programs can enhance their role in public health response efforts.

Reported Adverse Events (Side Effects) Following COVID-19 Vaccination Among University Students and Staff: A Case of Islamic University in Uganda

2025-10-29T20:01:46+00:00

Background: Since its outbreak, COVID-19 has brought several disastrous effects on the healthcare and economic systems of different countries globally. There is still no approved curative medicine for COVID-19; thus, the disease can only be controlled through preventive measures, especially vaccination through herd immunity. However, this is still far from being realized, as vaccination is still being affected by hesitancy and resistance from people, mainly due to the fears of side effects and other adverse events following vaccination. Therefore, understanding the incidence and associated factors, nature, and management of these adverse events is paramount for ensuring public confidence in vaccination programmes. The current study therefore aimed at documenting reported adverse events following COVID-19 vaccination among students and staff at the Islamic university in Uganda.
Methodology: This was a cross-sectional study design that was prospective in nature that recruited staff and students from Islamic University in Uganda that received COVID-19 vaccination between February and June 2022. Data was collected using Google Forms; participants were reached through the institutional ERP, emails, text messages and WhatsApp (social media). Data analysis was done using SPSS version 20.
Results: The study recruited 225 participants; 64.0% were female, and the median age range was between 26 and 30 years. Most of the respondents, 76.4%, reported receiving at least one side effect. More than 73% did not report any comorbidity (chronic conditions). 70.5% had received two doses of COVID-19 vaccines, and AstraZeneca was the most received brand at 51.8%. Most participants reported minor side effects, including pain at the injection site (44.4%). fever, chills, headache, and dizziness at 18.1%, and muscle pains and backpains at 14.6%. Only 1.2% reported vaccine sexual reproductive health.
Conclusions and Recommendation: The study confirms that COVID-19 vaccines are safe, as most of the reported side effects were minor with no life-threatening events. More sensitization of the community about the safety of vaccines is encouraged. Ongoing pharmacovigilance surveys for COVID-19 vaccines are recommended to detect possible long-term side effects.

Effects of the COVID-19 Pandemic on Livelihoods and Social Support Mechanisms in Selected Regions of Tanzania: A Qualitative Study

2025-10-29T20:01:47+00:00

Background: The coronavirus disease 2019 (COVID-19) has contributed to massive disturbances in people’s economic, social, and cultural affairs. Such experiences were brought about by the pandemic itself and the intervention measures put in place to contain the transmission of the disease. This study assessed the impacts of the COVID-19 pandemic on social and economic dimensions in selected regions of Tanzania.
Methods: The study was conducted in Unguja, Pemba and Dar es Salaam, Tanzania, employing a qualitative design. Thirty four interviews were conducted with key informants at the national, regional and district levels, comprising influential people, leaders, and healthcare workers. A total of 14 focus group discussions with community members and health care workers were conducted. All data were thematically analysed.
Results: Study participants revealed the main impact of COVID-19 to be on businesses and trade, with loss of wage earnings due to a reduction in touristic activities and flow from abroad of essential goods for trade. This, in turn, was reported to affect people’s purchasing power to fend for themselves, causing food insecurity at the household level. Trading activities of essential goods such as sugar and cooking oil were affected due to the reduction of their importation, which in turn caused their rental prices to rise. Restrictions imposed on gatherings created an atmosphere of fear that harmed traditional forms of support in times of need.
Conclusion: The findings from this study demonstrates how COVID-19 mitigation strategies significantly disrupted the social and economic fabric of the communities studied. We recommend that future pandemic preparedness plans should prioritize the implementation of comprehensive support programs for at-risk households and enact price controls on essential goods to protect the most vulnerable from economic hardship.

Xpert MTB/RIF Ultra Ct Value: A Quick Indicator of Sputum Bacillary Load and Smear Status Prediction in Individuals with Pulmonary Tuberculosis

2025-10-29T20:01:47+00:00

Background: Tuberculosis (TB) remains a global health threat, necessitating continuous advancements in diagnostic techniques for effective management and control. This study aimed to evaluate the diagnostic utility of smear microscopy and the Xpert MTB/RIF Ultra test in TB diagnosis, focusing on the correlation between Cycle threshold (Ct) values and disease severity.
Methods: A prospective cross-sectional study was conducted in the Kilimanjaro region, enrolling 472 participants suspected of pulmonary TB. Sputum samples were subjected to smear microscopy, and Xpert MTB/RIF Ultra testing. Data were analysed using R software. The ROC curve was created to assess the performance of the Ct values, and Spearman’s correlation and Mann-Whitney test to evaluate the association of Ct value and smear microscopy. Ethical approval was obtained from local and national ethical review boards.
Results: The study revealed discrepancies between smear microscopy and Xpert MTB/RIF Ultra, testing in identifying patients with high bacterial loads. The Ct value in predicting the smear grading yielded a sensitivity of 71% (95% CI 55.2 – 82.7) and specificity of 79.2% (95% CI 64.1 – 89.2), with an area under the curve (AUC) of 0.806. Analysis of Ct values revealed a negative correlation with smear grading, suggesting the potential utility of Ct values as predictive biomarkers for disease severity.
Conclusion: This study underscores the importance of advanced diagnostic techniques, such as the Xpert MTB/RIF Ultra test, in enhancing TB diagnosis and management. The correlation between Ct values and disease severity highlights the potential of Ct values as predictive indicators, offering promising prospects for personalized treatment strategies. Addressing discrepancies between diagnostic methods and further research into Ct value correlations are essential for refining TB diagnostic protocols and improving patient outcomes globally.

Changes in Sexual Risk-taking Behaviours Among Men After Participating in the PEST4MEN HIV Self-Testing Intervention in Two Fishing Communities in Central Uganda

2025-10-29T20:01:47+00:00

Background: The availability of free HIV self-test kits in the community may alter people’s sexual behaviours in some way. However, little evidence exists to confirm or refute this assertion. We assessed changes in sexual risk-taking behaviours among men living in a fishing community before and after participating in an HIV self-testing (HIVST) intervention.
Methods: This was a secondary analysis of data collected as part of a large peer-led HIVST intervention for men (PEST4MEN) in two fishing communities located in Kalangala (1) and Buvuma (1) Island districts. Following a baseline interview in July 2022, enrolled men (n=400) received oral fluid-based HIV self-test kits from their peer leaders and were followed up in September 2022 (n=361) to determine use. Data were collected on socio-demographic and behavioural characteristics using a structured questionnaire, configured in the KoboCollect tool, and loaded on mobile phones. We assessed changes in the proportion of men reporting multiple (2+) sexual partners, alcohol use before sex and condom use frequency before and after HIVST. We conducted descriptive analysis using STATA (version 14.0). Comparisons between proportions were made using Pearson’s chi-square test.
Results: Of 361 men, 239 had complete HIVST and sexual behaviour data at the baseline and follow-up visits. Of these, 34.3% (n=82) were aged between 25 and 34 years with a mean age of 30.8 years (Standard Deviation: ±9.0). Fifty-six percent (n=134) were engaged in fishing or fishing-related activities. The proportion of men reporting multiple sexual partners reduced significantly from 52.3% (n=125) to 42.3% (n=101), P=.0279. However, there was a non-significant increase in condom use at last sex (from 17.2%, n=41, to 18.4%, n=44; P=.7197) and alcohol use before sex (from 10.0%, n=24, to 11.7%, n=28; P=.5568). Consistent condom use reduced somewhat between the two study visits (from 10.0%, n=24, to 8.0%, n=19; P=.4241).
Conclusion: The proportion of men reporting multiple sexual partnerships reduced significantly between the two study visits. However, this reduction was not observed in the other sexual risk behaviours. These findings suggest a need for integrating sexual risk-reduction messages into HIVST interventions in order to reduce sexual risk-taking behaviors among potential users of HIV self-test kits.

How Anemia Perceptions Shape Dietary Diversity Practice in Pregnancy: A Health Belief Model Study in Tanzania

2025-10-29T20:01:47+00:00

Background: Maternal dietary diversity can significantly impact pregnancy outcomes for both the mother and the fetus. A varied and balanced diet during pregnancy provides crucial nutrients that support the baby’s growth and development, as well as the mother’s overall health, including being free from maternal anaemia. However, not much is known about the maternal dietary diversity practice in Tanzania. Identifying the magnitude and addressing the possible factors associated with maternal dietary diversity would have a significant contribution to enhancing the nutritional and health status of both the mother and her fetus. The use of the health belief model in this study helped to identify the belief factors influencing the behavioral practice, and this marked the aim of this study.
Methods: This was a community-based analytical cross sectional study that was conducted in Ilala Municipality. It involved 367 pregnant women with gestational ages ranging from 13 to 40 weeks who were selected using a multistage sampling. The data were collected using an interviewer administered structured questionnaire. The data was described using descriptive statistics, and a Pearson correlation test and a linear regression model were used to determine the associations between the outcome variable and its explanatory variables. A standardized beta coefficient, a 95% confidence interval (CI), and a P value were reported. A statistically significant variable in the final model was declared at the P value of <.05.
Results: Nearly half of the participants were between the ages of 25 and 34 years (46.4%) and (45.2%) were primigravida. Only (35.1%) of women had good dietary diversity practice with a mean dietary diversity score of 3.97±1.4. The food groups that were mostly consumed were grains and tubers (100%), dark green leafy vegetables (61.3%) and other types of vegetables (53.7%). The majority of pregnant women (84.7%) believed they are at high risk of getting anaemia in any stage of pregnancy. Over 90% of pregnant women believed that anaemia in pregnancy can led to foetus complications, and maternal and foetus death. Substantial proportion of pregnant women reported barriers to access and afford iron rich food. Predicators of good dietary diversity practice for the studied pregnant women include perceived moderate risk of anaemia (Beta = 0.19; CI = 0.2 -1.8), and perceived high severity (Beta = -0.09; CI = -0.7 - 0.01), having a higher education level (Beta = 0.8; CI = 0.1 -0.8).
Conclusion: Pregnant women are not meeting adequate nutritional requirements. Accessibility and costs are barriers that contribute to low consumption of vitamin A-rich fruits, eggs, nuts, seeds, and dairy products. Higher education level, perceiving the risk, and severity of anaemia during pregnancy are the predictors of good dietary diversity practice. We recommend a tailored intervention, highlighting the risk and severity of pregnancy-related anemia and the benefits of dietary diversification with locally available iron sources..

Exploring Emotional Violence in Intimate Relationships during Pregnancy in Central Tanzania: A Qualitative Descriptive Study

2025-10-29T20:01:47+00:00

Background: During pregnancy and the puerperal period, women become more sensitive both physically and emotionally, making them particularly vulnerable to Intimate Partner Violence (IPV). Despite this heightened vulnerability, emotional violence in intimate relationships during pregnancy remains under-researched. This study aimed to address this gap by exploring the experiences of emotional violence among pregnant women in central Tanzania.
Method: This study employed a qualitative descriptive study design, utilizing purposive sampling to recruit twenty-nine (29) participants for both in-depth interviews (IDIs) and Focus Group Discussions (FGDs). The respondents were post-delivery mothers with infants aged 42 days to six months. Data analysis was conducted using an inductive thematic approach.
Results: The women who participated in the study were, on average, 27.76 years old, with ages ranging from 19 to 43 years. Most of the women had attained only a primary level of education and resided in rural areas. Thematic analysis of their experiences revealed five key themes related to emotional violence during pregnancy: frequent conflict and arguments, verbal abuse and insults, emotional trauma resulting from persistent mistreatment, neglect and abandonment by partners, and coercive control marked by degrading and manipulative behavior.
Conclusion: These findings highlight the multifaceted nature of emotional intimate partner violence and its profound impact on pregnant women’s mental health. Addressing these issues requires comprehensive strategies that include raising awareness, enhancing support systems, and implementing targeted interventions to protect and empower women during this vulnerable period. Keywords: Emotional Violence, Intimate Partner, Experiences, Pregnancy, Tanzania.

Prevalence, Preventive Methods, Health-related Outcomes, and Correlates of Sexual Behaviours among Adolescents in Malinyi District Council, Morogoro region, Tanzania

2025-10-29T20:01:47+00:00

Background: Social media, peers, teachers, parents, religious leaders, and close family members are just a few of the many sources of sexual and reproductive health (SRH) information, education, related healthcare services, and rights that teens are inundated with for reproductive health, including safe sexual behaviors. This study evaluated the prevalence, preventive methods, health-related outcomes, and correlates of sexual behaviors among adolescents in the Malinyi district council, Morogoro region, Tanzania.
Methods: An analytical cross-sectional study was conducted on 331 randomly selected in-school adolescents. The major data-gathering tool was interviewer-administered structured questions from prior studies. The data were analyzed using version 25 of the IBM Statistical Package for Social Sciences (SPSS), with a 95% confidence interval and a 5% significance level.
Results: The average age of respondents was 13 years ± 0.91, with 54.1% being female. 86.0% of respondents were sexually active before the age of 19 years, of which 48.0% of them had sex with friends, 11.1% with mobile phone salespeople, 9.1% with motorcycle drivers, and 1.7% with their biological parents. 44.0% of adolescents reported using no any type of contraception during sexual activity, while 8.7% and 13.3% reported using plastic bags and Vaseline jelly, respectively. Adolescents who experienced verbal sexual jokes (AOR = 2.009; p<.05; 95%CI: 1.1.012-4.912), physical/tactile sexual jokes (AOR = 1.905, p<.05; 95%CI: 1.011-3.397), owning smartphones (AOR = 1.310; p<.05; 95%CI: 1.022-3.365), discussing family planning with friends (AOR = 2.300; p<.05; 95%CI: 1.013-3.321), and using social media platforms (AOR = 1.708; p<.05; 95%CI: 1.030-3.431) were at significant risk of early onset of unsafe sexual behaviors than others (p<.05).
Conclusion: Early onset of sexual behaviors among adolescents is still prevalent. Engaging in sexual activities with individuals closest to them, as well as others who were their blood family, utilising medically unapproved means such as plastic bags and Vaseline jelly during sexual activities, are common among adolescents. The study suggests system-wide school-based interventions to provide adolescents with age-appropriate and comprehensive SRH education and information for the delayed onset of sexual activities.

Variations in postnatal care (PNC) interventions provided to newborns in health facilities across Kakamega County, western Kenya

2025-10-29T20:01:47+00:00

Introduction: Neonatal mortality remains high globally, with Kenya reporting a rate of 20 deaths per 1,000 live births. Essential Newborn Care (ENC) is crucial for preventing neonatal deaths, yet the provision of this care for the newborns is varied.
Methods: This cross-sectional analytical study evaluated the provision of PNC-ENC across four scheduled visits in Kakamega County, Kenya. Data were collected from 325 mothers through structured questionnaires. Descriptive and inferential statistics, including ANOVA, were used to assess care provision.
Results: The overall mean provision of expected newborn interventions across the four visits was 57.82%. Provision was highest at the first visit (59.55%), declined at 2 to 4 weeks (55.16%), improved at 4 to 6 weeks (59.06%), and slightly declined at 4 to 6 months (57.50%).
Conclusions: This study highlights gaps in the delivery of essential newborn care, particularly in physical examinations. Targeted interventions, including training and resource allocation, are recommended to improve provision to PNC care interventions and reduce neonatal mortality.

Emergency Contraceptives Use Among Female Commercial Sex Workers in Tanzania; A Cross-Sectional Study

2025-10-29T20:01:48+00:00

Background: Unintended pregnancies pose a significant health risk for Female Commercial Sex Workers (FCSW), a highly vulnerable population. Despite the availability of emergency contraceptives (EC) to prevent such outcomes, concerns still exist regarding potential misuse as a regular contraceptive method, and the specific factors influencing EC use among FCSWs remain underexplored. This study aimed to evaluate the prevalence and determinants of EC use among FCSWs to address this critical knowledge gap.
Methods: This analytical cross-sectional study involved 326 randomly selected female commercial sex workers in Tanzania. Data were collected using a structured questionnaire created from previous literature and analyzed using SPSS version 29. Given the sensitive nature of this population, detailed ethical procedures were followed to ensure voluntary participation and confidentiality. Our sampling approach utilized community-based outreach rather than a formalized registry.
Results: The study found that a significant majority of the respondents (64.4%) had never used EC. Multivariate logistic regression analysis identified several key factors independently associated with EC use. Education level showed an inverse relationship, with those having ordinary secondary education (AOR=0.37, 95% CI=0.16-0.88, P=.024) and college-level education (AOR=0.13, 95% CI=0.04-0.47, P=.002) being significantly less likely to use EC compared to those with no formal education. Furthermore, a history of drug use was strongly associated with a reduced likelihood of EC use (AOR=0.35, 95% CI=0.19-0.61, P<.001). Conversely, prior awareness of emergency contraceptives emerged as a powerful predictor of use, with those who had ever heard about EC being substantially more likely to use them (AOR=6.20, 95% CI=3.44-11.17, P<.001).
Conclusion: The use of emergency contraceptives among FCSW is still low for various reasons including educational attainment, and drug use. While awareness is a strong facilitator of EC use, higher education levels surprisingly showed an inverse relationship. This suggests that interventions are needed to address the unique barriers faced by this vulnerable group, including misconceptions among the educated and the compounding challenges posed by drug use. Several approach combining comprehensive education, integrated health services, and sustained awareness campaigns is essential to improve EC access and utilization for FCSW.

Neonatal Resuscitation Practices and Associated Factors Among Nurses in Tanzanian Delivery Suites: A Cross-Sectional Study

2025-10-29T20:01:48+00:00

Background: Neonatal deaths contribute significantly to under-five mortality, with most deaths seen in sub-Saharan Africa (SSA). Birth asphyxia is the leading cause of these deaths, but it is preventable with effective resuscitation. In SSA, including Tanzania, inadequate neonatal resuscitation practice by health care providers has been identified as a significant contributor to neonatal mortality.
Aim of the study: The study aimed to assess the current practice of neonatal resuscitation and the associated factors among nurses located in the delivery suites.
Methodology: A hospital-based cross-sectional study was done at Muhimbili National Hospital. It involved the direct observation of 138 cases of neonatal resuscitation(NR) by 49 nurses. Proportions were used to assess practice. The chi-square and Fisher’s Exact Tests were used to determine associations between provider characteristics and practice. Logistic regression models were used to identify independent predictors of practice.
Results: Overall, 52% of neonatal resuscitation cases met standard guidelines. Adequate drying was performed in 82.6% of cases, but inappropriate stimulation occurred in 16,7%, and wet towels were discarded in only 38.4%. Initial assessment was correct in 49.6%, and airway opening in 73.3%. A good mask seal was achieved in 93%, yet the first rescue breath was correctly given in 32.1% and the second course in 27.2%. One newborn required chest compressions, but they were incorrectly done. Documentation post-resuscitation was done in only 2.9% of cases. Formal training (cOR 0.181; 95% CI, 0.038 to 0.871; P=.033), in-house training (P=.049), work experience (cOR 0.368; 95% CI, 0.161 to 0.839; P=.017), and knowledge of neonatal resuscitation (cOR 0.392; 95% CI, 0.197 to 0.781; P=.008 were associated with neonatal resuscitation practice. Working experience of 3 to 5 years (AOR .352; 95% CI, 0.148 to 0.836; P=.018) was found to be an independent predictor of practice.
Conclusion and recommendation: Neonatal resuscitation is still a challenge among providers working in delivery suites. Working experience is an independent predictor of practice, but other factors, such as knowledge level, training, and ongoing in-house training, are equally important. Regular training, integration of neonatal resuscitation into continuous professional development, and embedding resuscitation performance in quality improvement frameworks are recommended.

Comparative Analysis of Surgical Outcomes Between Open Herniotomy and Laparoscopic Hernia Repair Among Pediatric Patients with Inguinal Hernias: A Five-Year Retrospective Review at Tanzania’s National Hospital

2025-10-29T20:01:48+00:00

Background: Inguinal hernias (IH) are common congenital anomalies in children, requiring surgical repair to prevent complications. The primary methods for repairing pediatric IH are laparoscopic hernia repair (LHR) and open herniotomy (OH). However, there is limited evidence comparing postoperative outcomes between these approaches in Low- and Middle-Income Countries (LMICs).
Objective: To compare postoperative outcomes between OH and LHR among pediatric patients treated at Muhimbili National Hospital (MNH) in Tanzania.
Methodology: This 5-year retrospective comparative cohort study included 156 pediatric patients under 14 years who underwent OH or LHR at MNH from January 2019 to December 2023. Participants were selected using a hybrid random-consecutive sampling technique. LHR and OH patients were recruited at approximately a 1-to-4 ratio. Data was collected from patient records and via phone interviews. Inferential statistical tests were used to compare the outcomes of the two surgical methods.
Results: Participants had a median age of 19.5 months (IQR 10–36) at presentation, with the majority being male (142, 91%). The median age was slightly higher in the LHR group [21.5 (IQR 12–46.5)] compared to 19 months (IQR 9–36) in the OH group. In the subgroup analysis of bilateral hernias (n=22), measures such as the duration of surgery, postoperative length of stay, total hospitalization time, parents` satisfaction, and cosmetic rating favored LHR (p<.05). Satisfaction and cosmesis were also better with LHR for unilateral hernias (n=134) (p<.05). However, the overall recurrence rate was higher with unilateral LHR at 22.7% (5/17) compared to 4.5% (5/107) with OH, p<.05.
Conclusion: While LHR demonstrated shorter operative time, faster recovery, and favourable cosmetic outcomes, the potential for hernia recurrence warrants careful consideration when selecting the surgical approach. Given the inherent methodological limitations, these findings should be interpreted with caution. Nevertheless, the findings provide valuable preliminary evidence that can inform future larger-scale, well-powered studies aimed at evaluating the long-term outcomes of LHR in LMIC settings.

Evaluating the Knowledge and Practices of General Practitioners in Cardiovascular Risk Assessment at Three Referral Hospitals in Bujumbura, Burundi

2025-10-29T20:01:48+00:00

Background: Cardiovascular diseases (CVD) encompass a range of non-communicable conditions that share a common pathophysiological process related to atherosclerosis. Currently, CVD are the leading cause of death worldwide, with an estimated 17.9 million deaths attributed to these conditions in 2019. In Africa, the burden of CVD is steadily increasing, leading to a rise in years lived with disability. In Burundi, however, cardiovascular diseases are poorly documented, and there is a lack of data on the extent to which general practitioners (GPs) assess cardiovascular risk among their patients. This study aimed to evaluate the knowledge and practices of GPs regarding global cardiovascular risk assessment, providing evidence to inform policymakers and training institutions on potential strategies for improving cardiovascular care.
Methods: A descriptive, cross-sectional study was conducted in three national hospitals in Burundi: Centre Hospitalo-Universitaire de Bujumbura (CHUK), Hôpital Prince Régent Charles (HPRC), and Hôpital Militaire de Kamenge (HMK), all located in Bujumbura capital city. Study participants were general practitioners working in the outpatient departments of these hospitals. Data were collected using a validated questionnaire, and descriptive statistics were generated to analyse the findings. The level of knowledge regarding cardiovascular disease was assessed based on scoring systems derived from the questionnaire. The study received ethical approval from the Institutional Review Board of the Faculty of Medicine, University of Burundi.
Results: The participation rate was 86.8%, with 66 participants out of 76 completing the study. Among respondents, 68% had less than five years of professional experience. Only 40.9% demonstrated adequate knowledge of cardiovascular disease, and a mere 18.18% possessed sufficient knowledge of therapeutic objectives and treatment strategies. In practice, 77.3% of participants reported routinely assessing cardiovascular risk; however, 42% of those in need of lipid-lowering therapy did not prescribe such medications, highlighting gaps between clinical practice and guideline adherence
Conclusions: Identified gaps in the knowledge, attitudes, and practices of general practitioners concerning cardiovascular disease prevention highlight the need for decision-makers, training institutions, and universities to prioritise the development of ongoing in-service training programmes to enhance their capacity in this area.

Awareness and Risk Reduction of Hypertension Among Adults in Ilala and Mkuranga Districts, Tanzania

2025-10-29T20:01:48+00:00

Background: Hypertension is one of the major global public health problems that has been associated with an increasing prevalence of cardiovascular diseases (CVDs) such as stroke and ischemic heart disease. This study aimed to assess awareness and the practice of risk reduction of hypertension among adults in Ilala and Mkuranga districts, Tanzania.
Methods: A community based cross sectional study was conducted whereby a total of 295 participants were interviewed using a questionnaire adapted from the World Health Organization (WHO). Stepwise approach for chronic disease risk factor surveillance was used to obtain the socio-demographic information, knowledge, awareness, and attitudes regarding hypertension using a structured set of questions. Blood pressure was measured and recorded. Descriptive statistics were used to describe and summarize the study findings. Pearson Chi-square test was used to compare and determine the association between categorical variables and hypertension. Multiple logistic regression analysis was Results: performed to determine predictors of hypertension. Statistical association for all comparisons was set at P<.05.
Hypertension prevalence was high (36.9%) with high proportion of hypertensive individuals being aged between 30 to 44 years (48.6%), married or cohabiting (70.6%), self-employed (59.6%), attained primary education level (59.6%), earn <TZS 250,000 per month (47.7) and living in rural Mkuranga (48.6%). Over a third of hypertensive individuals were unaware of their condition. Although over half of studied individuals had good knowledge of risk factors for hypertension, their risk reduction practices were limited. Only 44.4% engaged in physical activity, 7.5% quit smoking, and 9.2% reduced their alcohol intake. However, in multiple logistic regression age and knowledge maintained its significant association with hypertension. Tailored community interventions are urgently needed to improve awareness and enhance preventive practices against hypertension.
Conclusion: This study underscores the urgent need for enhanced hypertension prevention strategies in study population. Significant gaps remain in awareness, risk perception, and adoption of preventive practices.

High Prevalence of Sickle Cell Disease in Low-Endemic Areas: A Pilot Study in Chunya, Tanzania

2025-10-29T20:01:48+00:00

Backround: Tanzania has the fifth highest prevalence of Sickle Cell Disease (SCD) worldwide. Annually, 11,000 children are born with SCD, but only 10% survive to their fifth birthday. Limited screening has led to underestimation of the burden in regions such as the southern highlands. The epidemiology of SCD, just like other diseases, is affected by climate change through increasing migration in search of arable land hence the shifts in the geographical prevalence of SCD from high prevalent areas to low prevalence areas. Early identification of SCD across all regions is therefore essential to improve survival, quality of life, mental health, reduce stigma, and alleviate the financial burden.
Study Objective: The objective of the study was to assess the prevalence of SCD and SCT in Chunya district, Mbeya Region, Tanzania and to identify demographical factors associated with the risk of SCT among community members.
Methods: A cross-sectional study on SCD was conducted in Chunya district, Mbeya Region, between 21st and 22nd February 2020. A total of 523 villagers were selected and screened for SCD and sickle cell trait (SCT) using rapid test (SICKLE SCAN (®).
Results: The study revealed a notably high prevalence of SCD in southern highlands of Tanzania which highlighted the need for early screening and community-based awareness programs. The prevalence of SCD in the tested population was 1.91% and the prevalence of SCT was 8.41% of which the majority of the SCD patient were five years and below P= .02. Having a mother from Southern Zone was a protective factor (OR 0.2) against acquiring SCT while having a father from Northern Zone was a risk factor (OR 10), P value <.005.
Conclusion: To reduce the burden of SCD, new strategies of screening should be developed to enable timely diagnosis and management of the disease.

Gut Microbiota Dysbiosis and Associated Gut Health Outcomes Among Alcohol Consumers in Musanze District of Rwanda: A Cross-Sectional Study

2025-10-29T20:01:48+00:00

Background: Excessive consumption of alcohol contributes to gut dysbiosis, leading to adverse gut health outcomes such as gastrointestinal diseases. About 1.6%, or 200,000, Rwandans between 14 and 64 years old abuse alcohol. But there is a paucity of information on the effects of alcohol on intestinal health. This was a cross-sectional study carried out to determine the gut microbial imbalance and associated outcomes among alcohol consumers in the Musanze district.
Methods: A total of 50 participants were recruited, of which 25 were alcohol consumers, while the remaining 25 were control subjects. Stool samples were collected and transported to the INES Ruhengeri clinical microbiology laboratory for microbial identification. Gut outcomes associated with alcohol consumption were evaluated by an interview-administered questionnaire. An independent t-test was performed to test for the microbial mean difference between alcohol consumers and non-alcohol consumers, while a chi-square test was performed to evaluate associations between gut dysbiosis and outcomes.
Results: Escherichia coli (17.5%) was the most predominant among alcohol consumers, while Lactobacillus (17.3%) was the most predominant among control subjects. There was a significant association between alcohol consumption and gut microbial alteration to E. coli (x² = 4.2, P=.04), Enterococcus faecalis (x² = 9.9, P=.00165), Lactobacillus sp. (x² = 16.4, P=.000051), Bacillus sp. (x² = 5.8, P=.016), S. epidermidis (x² = 11.7, P =.000625), S. pyogenes (x² = 3.9, P=.048), and the overall association was statistically significant (x² = 65.75, P ˂.00001). The association between gut microbiota dysbiosis and gut health outcomes was also significant for Pseudomonas aeruginosa (x² = 18.3, P=.001078), S. pyogenes (x² = 12.1, P=.016623), Enterococcus faecalis (x² = 11, P=.026564) and the overall association (x² = 113.703, P<.00001) with the imbalanced microbiota and outcomes being statistically significant. The odd ratio (OR) for pathogenic bacteria to non-pathogenic bacteria was OR = 5.11˃1.
Conclusion: Alcohol consumption is associated with gut microbiota dysbiosis, which predisposes to intestinal disorders. Excessive consumption of alcohol should be stopped to prevent devastating outcomes to intestinal health.

Prevalence and Risk Factors of Hypotension in Patients Undergoing Caesarean Section with Spinal Anaesthesia at Muhimbili National Hospital

2025-10-29T20:01:49+00:00

Background: Spinal anaesthesia is a common regional technique for caesarean sections, but is associated with hypotension in up to 80% of patients. Preventive measures include; intravenous fluid preloading, left uterine displacement, compression stockings, and vasopressors. This study aimed to determine the prevalence and risk factors of hypotension during spinal anaesthesia in pregnant patients undergoing caesarean section at Muhimbili National hospital.
Methods: A descriptive cross-sectional study was conducted at Muhimbili National Hospital’s Obstetric theatre, involving patients who received spinal anaesthesia during caesarean section from August 2021 to January 2022. The study excluded patients with sedation, anti-hypertensive, pregnancy-induced hypertension, modified Bromage score, or combination anaesthesia. Data was collected, and analysed using SPSS version 20.
Results: A total of 300 patients were enrolled (calculated sample size 270 plus 10% margin). Of these, 33.3% underwent elective caesarean section and 66.7% emergency caesarean section. Most patients (92%) received 0.5% hyperbaric bupivacaine, while 8% received 5% heavy lidocaine. Hypotension occurred in 56.7% of patients (95% CI: 0.511–0.623). Risk factors included preload <10 mL/kg, higher sensory block levels, and absence of wedge positioning.
Conclusion: Hypotension during spinal anaesthesia for caesarean section is common. Preventive measures, including adequate fluid preload, wedge positioning, and careful monitoring of sensory block height, are essential to improve maternal hemodynamic stability.

Knowledge on CLABSI Prevention Strategies and Associated Factors Among ICU Nurses in Dar es Salaam

2025-10-29T20:01:49+00:00

Background: Central line-associated bloodstream infection (CLABSI) is one of the major complications for patients with central lines (CLs) and a leading hospital-acquired infection. This infection is associated with increased length of hospitalization, medical costs, high morbidity, and mortality. As primary caregivers for patients with CLs in the ICU, nurses are crucial in preventing CL-related infections and complications. Despite this key role, there is limited knowledge about ICU nurses’ understanding of CLABSI, especially in low-income countries like Tanzania.
Aim: This study aimed to assess knowledge on CLABSI prevention strategies and associated factors among ICU nurses in Dar es Salaam, Tanzania.
Methods: A quantitative cross-sectional analytical study was conducted among 250 ICU nurses in 3 tertiary hospitals. Data were collected from May to July 2023 using a self-administered questionnaire, with CLABSI knowledge assessed using 32 items. SPSS version 25 was employed to analyze data, and logistic regression was performed to identify factors associated with knowledge of CLABSI prevention strategies. In all analyses, statistical significance was set at a p-value <.05.
Results: The mean knowledge score was 52.2% (SD = 10.7), with a median of 50%. Among the participants, only 52 (28.2%; 95% CI: 22.6%–33.8%) demonstrated a high level of knowledge regarding CLABSI prevention strategies and care. Receiving in-service CL training (AOR = 5.20; 95% CI: 1.79–15.07; p =.002), the availability of CLABSI prevention guidelines (AOR = 2.52; 95% CI: 1.05–6.03; p=.038), and the absence of pre-service CL training (AOR = 3.05; 95% CI: 1.33–6.97; p=.008) were significantly associated with higher knowledge of CLABSI prevention strategies and care.
Conclusion: ICU nurses demonstrated generally inadequate knowledge of CLABSI prevention strategies, with less than one-third (28.2%) showing a high level of knowledge. In-service CL training, availability of CLABSI guidelines, and absence of pre-service training were significantly associated with higher knowledge, suggesting the strong influence of practical, workplace-based learning. Targeted in-service training and consistent provision of evidence-based guidelines are essential to strengthen ICU nurses’ competence, reduce CLABSI incidence, and improve patient safety.

Factors Associated with Evidence-Based Decision-Making Among Specialized Nurses Working in Selected Health Facilities in Nairobi, Kenya

2025-10-29T20:01:49+00:00

Background: Evidence-Based Decision-Making (EBDM) is central to quality nursing practice, yet many nurses continue to rely on intuition when making clinical decisions. In low-resource settings such as Kenya, limited access to information, knowledge-sharing barriers, and institutional constraints further hinder EBDM. Understanding the factors that influence EBDM among specialized nurses is vital for improving patient care and health system outcomes.
Methods: This study employed a concurrent nested mixed-methods design guided by the ACE Star Model. The quantitative arm utilized a cross-sectional census of 51 maternal and child health nurses from four public hospitals in Nairobi, while the qualitative arm involved two in-depth interviews with supervisors. Data were collected using a structured questionnaire and interview guide. Quantitative analysis was conducted using SPSS with logistic regression to identify factors associated with EBDM, while qualitative data were analyzed thematically.
Results: The overall response rate was 100%. Most respondents (72.5% female) were diploma holders with a median age of 30 years. Findings revealed that the predominant reliance on intuition was significantly associated with low utilization of EBDM (p=.039). Individual factors, including skills, incentives, and research literacy, were strongly associated with EBDM utilization (p=.001). Married nurses and those with higher academic qualifications demonstrated marginally lower odds of low EBDM utilisation. Institutional factors and barriers such as limited internet access, staffing constraints, and time shortages were reported but not statistically significant. Qualitative insights highlighted reliance on tacit knowledge, bounded autonomy, and workload pressures as major influences on decision-making.
Conclusion: Specialized nurses in Nairobi largely rely on tacit knowledge and intuition, with individual capacities playing a critical role in shaping EBDM. Strengthening research skills, integrating EBDM training early into nursing curricula, and creating institutional support systems are essential for enhancing evidence use in clinical practice. Strategies for capturing and translating tacit knowledge into actionable evidence should be prioritized to improve patient outcomes. Further large-scale, multidisciplinary studies are recommended to validate these findings.

Barriers to Early Initiation of Breastfeeding: A Hospital-Based Qualitative Study

2025-10-29T20:01:49+00:00

Background: Breastfeeding is a key intervention to improve global targets on nutrition, health and survival. The World Health Organization recommends initiating breastfeeding within the first hour of birth to prevent infections, strengthen neonatal- maternal bonding, maintain thermoregulation and promote long term breastfeeding success. Global prevalence of early initiation of breastfeeding is 46% while in Tanzania it is 70%. The target set by the Baby Friendly Hospital Initiative guidelines for hospital deliveries is at least 80%.
Objectives: This study aimed to explore barriers to early initiation of breastfeeding in a hospital setting using a descriptive qualitative approach.
Methods: Semi-structured individual interviews were conducted to explore barriers to early initiation of breastfeeding from the perspective of midwives and post-partum mothers. Data was analysed using Systematic Text Condensation as described by Malterud.
Results: Participants perceived that inadequate and sometimes conflicting information during antenatal period, especially on ideal time to start breastfeeding contributed to delayed initiation. Post-delivery practices such as perineal tear repair, along with environmental factors, including perceptions of unclean labour rooms and the presence of male personnel in the delivery room further hindered timely initiation. Overall, barriers were linked to gaps in knowledge, non-conducive postpartum environments and restrictive hospital practices.
Conclusions: Improving early initiation of breastfeeding requires policies and programs aimed at strengthening the provision of breastfeeding related education to mothers during antenatal visits and enhancing the knowledge of midwives. At the health facility level, creating a supportive post-partum environment with individualised care, and implementing evidence-based practices are essential for promoting timely initiation.

Artificial Intelligence and Medical Education (2013-2024): A Scopus-Based Bibliometric Analysis

2025-10-29T20:01:46+00:00

Background: Artificial Intelligence (AI) is transforming medical education by enabling personalised learning, adaptive feedback, simulation-based training, and automated assessments. While AI offers significant benefits, including curriculum optimisation and virtual tutoring, concerns around data privacy, access, and ethical implementation persist. Although bibliometric studies have explored AI in healthcare, comprehensive analyses of global collaboration and publication trends in AI-focused medical education remain limited.
Aim: This study aims to analyse global research trends, key contributors, and thematic developments in the application of AI within medical education.
Methods: A bibliometric analysis was conducted using the Scopus database. The search strategy included terms such as “Medical Education”, “Artificial Intelligence”, “Machine Learning”, “Deep Learning”, “Clinical Training”, “Virtual Patients”, and “Simulation”. Data were analysed using the Bibliometrix R package to assess publication volume, keyword co-occurrence, author collaboration, and citation patterns.
Results: Research output on AI in medical education has grown significantly, peaking in 2024 with 1,081 publications. The United States leads in publication volume, followed by Russia and Canada. “Artificial Intelligence” was the most frequently used keyword. Co-authorship and co-citation networks revealed strong international collaboration, with emerging themes in clinical competence, virtual simulation, and ethical considerations.
Conclusion: The future of artificial intelligence in medical education is promising, with applications in personalised treatment plans, drug development, and virtual healthcare assistants. AI has transformative potential for medical education, particularly in personalised learning and simulation-based training. Strategic investment in AI literacy, ethical frameworks, and infrastructure is essential to ensure equitable and effective integration across global contexts.

Reccurent sigmoid volvulus in pregnancy: Case Report

2025-10-29T20:01:46+00:00

Sigmoid volvulus in pregnancy is a rare condition occurring during the third trimester with a high recurrence rate and having fatal complications to both fetus and mother. It requires a prompt diagnosis and multidisciplinary approach.
We present a case of a 33 year old, pregnant woman, Gravida 4, Para 3, at 32 weeks of gestation, who presented with abdominal pain, distension, and tenderness. A Plain abdominal X-ray showed a dilated loop of the sigmoid colon. This was her second admission with similar symptoms. Having previously diagnosed with sigmoid volvulus one month earlier, she was treated conservatively, recovered, and discharged. On this admission she was diagnosed with recurrent sigmoid volvulus, after stabilization she underwent laparotomy which revealed sigmoid colon volvulus at 180 degrees twist. A resection of redundant sigmoid was done, resulting in uneventful postoperative care, discharge, and follow-up.
A timely diagnosis and surgical interventions, especially through a multidisciplinary approach during late gestation can lead to favorable outcome for the baby and mother.